By Mishel Unar-Munguía, Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico, and Cecilia Fabrizio, ST4N Program Lead
The COVID-19 pandemic significantly impacted Mexico’s economy and food and health systems, leading to increased poverty and food insecurity, and exacerbating an already large burden of maternal and child malnutrition.
A warning for decision makers
In 2021, the Standing Together for Nutrition Consortium (ST4N) sounded the alarm,1 warning that the pandemic’s fallout could significantly increase the risk of child wasting, stunting, and deaths in low- and middle-income countries.
Recently, a study by Mexico’s National Institute of Public Health,2 supported by ST4N, shed further light on this critical issue. In depth analysis of representative nutrition surveys from Mexico predicted a 6.4 percent increase in stunting (+0.9 pp) and a 4 percent increase in child mortality (+0.5 pp) in 2021 compared to before the pandemic in 2018, with similar rates observed across rural and urban areas. In addition, there was a 20 percent increase in food insecurity among households with children under the age of five.
Source: Unar-Munguía et al.
From bad to worse
Child malnutrition was already a problem in Mexico before the pandemic, but a combination of factors including rising unemployment, reduced income, and disruptions to essential nutrition and health services made the situation worse.
National surveys exposed the extent of the job and income losses. Poverty levels in Mexico rose by two percent during the first year of the pandemic (from 41.9 percent in 2019 to 43.9 percent in 2020).3 In the first five months of the pandemic (between February and June 2020), more than a third of households surveyed by the phone with children and/or adolescents experienced job losses and nearly three-quarters of all households experienced reduced income compared to pre-pandemic levels. More than 40 percent of these households reported a 30 percent reduction in income.4 Consequently, food insecurity increased (from 55.5 percent in 2018 to 59.1 percent in 2020),5 making it even more challenging for vulnerable families to afford a healthy diet.
The pandemic also disrupted essential nutrition services provided by the Mexican Institute of Social Security, which serves over half of the population. Antenatal care visits for pregnant women declined by over 25 percent between 2019 and 2020, while access to vaccinations for children decreased by a third, and access to sick child services was reduced by two-thirds.6
Investing in nutrition
The study also modeled the potential impact of increasing the coverage of health and nutrition services for pregnant women and children under five. The results were encouraging. By investing US$100 million annually in a basic package of nutrition interventions, Mexico could achieve substantial progress in combating child malnutrition. Projections indicate an 8.5 percent reduction in stunting and a 4 percent reduction in wasting, preventing nearly 4 percent of all child mortality cases by 2030.2
The proposed packaged would include treatment for severe acute malnutrition, micronutrient powders and vitamin A supplementation for children, prenatal supplements for pregnant women, and nutrition counseling for mothers and young children through health facilities, community outreach, and mass media, with the goal of decreasing malnutrition to pre-pandemic levels by 2030.2
Not only would this be a huge win for public health, but it could save a staggering US$5,290.3 million in costs associated with productivity losses and premature deaths due to malnutrition.
Source: Unar-Munguía et al.
This Mexico case study highlights the importance of taking swift action to mitigate the effects of crises on child malnutrition. Prioritizing access to safe, affordable, and nutritious diets is essential, and scaling up critical health and nutrition services are needed to ensure that the most vulnerable populations are not left behind. With the right investments, the long-term consequences of child malnutrition can be prevented, leading to a healthier and more productive future for all.
References
- Osendarp S, Akuoku JK, Black RE, et al. The COVID-19 crisis will exacerbate maternal and child undernutrition and child mortality in low- and middle-income countries. Nat Food. 2021;2(7):476-484. doi:10.1038/s43016-021-00319-4
- Unar-Munguía M, Cervantes Armenta M, Arbuto T, et al. Modeling the Effects of the COVID-19 Pandemic on Food Insecurity and Malnutrition and the Cost of Increasing Health and Nutrition Services Coverage for Children in Mexico; Report for ST4N Consortium (unpublished); 2020.
- Consejo Nacional de Evaluación de la Política de Desarrollo Social (Coneval). Coneval Presenta Las Estimaciones de Pobreza Multidimensional 2018 y 2020; 2021. https://www.coneval.org.mx/SalaPrensa/Comunicadosprensa/Documents/2021/COMUNICADO_009_MEDICION_POBREZA_2020.pdf
- EQUIDE, OEI, SIPINNA, Acción Ciudadana Frente a la Pobreza, UNICEF. Presentación de Resultados de La Encuesta de Seguimiento de Los Efectos de COVID-19 En El Bienestar de Niñas, Niños y Adolescentes; 2020. https://www.unicef.org/mexico/informes/encuesta-encovid19infancia
- Martínez MR, Barrientos-Gutiérrez T, Cuevas-Nasu L, et al. Metodología de la Encuesta Nacional de Salud y Nutrición 2021. Salud Pública México. 2021;63(6, Nov-Dic):813-818. doi:10.21149/13348
- Doubova SV, Leslie HH, Kruk ME, Pérez-Cuevas R, Arsenault C. Disruption in essential health services in Mexico during COVID-19: an interrupted time series analysis of health information system data. BMJ Glob Health. 2021;6(9):e006204. doi:10.1136/bmjgh-2021-006204
